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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  2d Session
                                  S. 3

 To amend title XVIII of the Social Security Act to waive cost-sharing 
      for advance care planning services, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

            December 20 (legislative day, December 16), 2024

 Mr. Warner (for himself, Ms. Collins, Ms. Baldwin, and Ms. Klobuchar) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL

 
 To amend title XVIII of the Social Security Act to waive cost-sharing 
      for advance care planning services, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Improving Access to Advance Care 
Planning Act''.

SEC. 2. MEDICARE COVERAGE OF ADVANCE CARE PLANNING SERVICES.

    (a) Advance Care Planning Services Defined.--Section 1861 of the 
Social Security Act (42 U.S.C. 1395x) is amended by adding at the end 
the following new subsection:
    ``(nnn) Advance Care Planning Services.--
            ``(1) In general.--The term `advance care planning 
        services' means a visit between an eligible practitioner (as 
        defined in paragraph (2)) enrolled under section 1866(j) and an 
        individual, a family member of such individual, or a surrogate 
        designated by such individual, to discuss--
                    ``(A) the health care preferences of such 
                individual;
                    ``(B) future health care decisions that may need to 
                be made by, or on behalf of, such individual; and
                    ``(C) advance directives or other standard forms, 
                which may be completed by, or on behalf of, such 
                individual.
            ``(2) Eligible practitioner.--For purposes of paragraph 
        (1), the term `eligible practitioner' means--
                    ``(A) a physician (as defined in subsection (r));
                    ``(B) a physician assistant (as defined in 
                subsection (aa)(5));
                    ``(C) a nurse practitioner (as defined in 
                subsection (aa)(5));
                    ``(D) a clinical nurse specialist (as defined in 
                subsection (aa)(5)); or
                    ``(E) a clinical social worker (as defined in 
                subsection (hh)(1)) who possesses--
                            ``(i) a relevant care planning 
                        certification; or
                            ``(ii) experience providing care planning 
                        conversations or similar services, as defined 
                        by the Secretary.''.
    (b) No Application of Coinsurance or Deductible Under Part B.--
            (1) Amount.--Section 1833(a)(1) of the Social Security Act 
        (42 U.S.C. 1395l(a)(1)) is amended--
                    (A) in subparagraph (GG), by striking ``and'' at 
                the end; and
                    (B) in subparagraph (HH), by striking the semicolon 
                at the end and inserting the following: ``and (II) with 
                respect to advance care planning services (as defined 
                in section 1861(nnn)) furnished on or after January 1, 
                2026, the amounts paid shall be 100 percent of the 
                lesser of the actual charge for the services or the 
                amount determined under the fee schedule established 
                under section 1848(b)''.
            (2) Waiver of application of deductible.--The first 
        sentence of section 1833(b) of the Social Security Act (42 
        U.S.C. 1395l(b)) is amended--
                    (A) by striking ``, and (13)'' and inserting 
                ``(13)''; and
                    (B) by striking ``section 1861(n).'' and inserting 
                the following: ``section 1861(n), and (14) such 
                deductible shall not apply with respect to advance care 
                planning services (as defined in section 1861(nnn)) 
                furnished on or after January 1, 2026''.
    (c) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after January 1, 2026.

SEC. 3. HHS PROVIDER OUTREACH.

    (a) Outreach.--The Secretary of Health and Human Services (in this 
section referred to as the ``Secretary'') shall conduct outreach to 
physicians and appropriate non-physician practitioners participating 
under the Medicare program under title XVIII of the Social Security Act 
with respect to Medicare payment for advance care planning counseling 
services furnished to individuals to discuss their health care 
preferences, identified by Healthcare Common Procedure Coding System 
(HCPCS) codes 99497 and 99498 (or any successor to such codes). Such 
outreach shall include a new, comprehensive, one-time education 
initiative to inform such physicians and practitioners of the addition 
of such services as a covered benefit under the Medicare program, 
including the requirements for eligibility for such services.
    (b) Report.--Not later than 1 year after the date of enactment of 
this Act, the Secretary shall submit to the Committee on Ways and Means 
and the Committee on Energy and Commerce of the House of 
Representatives and the Committee on Finance of the Senate a report on 
the outreach conducted under subsection (a). Such report shall include 
a description of the methods used for such outreach.

SEC. 4. MEDPAC REPORT ON THE FURNISHING OF ADVANCE CARE PLANNING 
              SERVICES AND THE USE OF ADVANCE CARE PLANNING CODES UNDER 
              THE MEDICARE PROGRAM.

    (a) Study.--The Medicare Payment Advisory Commission (in this 
section referred to as the ``Commission'') shall conduct a study on 
advance care planning under the Medicare program under title XVIII of 
the Social Security Act. Such study shall include an analysis of--
            (1) the furnishing of advance care planning services to 
        Medicare beneficiaries, including--
                    (A) which providers are trained to provide such 
                services;
                    (B) which providers are eligible to provide such 
                services under the Medicare program;
                    (C) the length and frequency of the visits for 
                furnishing such services; and
                    (D) any barriers related to providers furnishing, 
                or beneficiaries being furnished, such services;
            (2) the use of advance care planning Current Procedural 
        Terminology (CPT) codes to bill for the furnishing of advance 
        care planning services to Medicare beneficiaries, including--
                    (A) circumstances under which codes other than 
                advance care planning CPT codes are used to bill for 
                such services under the Medicare program and why 
                providers do not use advance care planning CPT codes; 
                and
                    (B) any barriers to providers using advance care 
                planning CPT codes to bill for such services under the 
                Medicare program; and
            (3) such other items determined appropriate by the 
        Commission.
    (b) Report.--
            (1) In general.--Not later than June 30, 2026, the 
        Commission shall submit to the Committee on Ways and Means and 
        the Committee on Energy and Commerce of the House of 
        Representatives and the Committee on Finance of the Senate a 
        report on the study conducted under subsection (a), together 
        with recommendations for such legislation and administrative 
        action as the Commission determines appropriate.
                                 <all>
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